Corneal Diseases
The cornea is the transparent structure located at the front of the eye. It acts like a window that allows light to enter and plays an active role in focusing images. Essential to the quality of vision, it also serves as a protective barrier against external aggressions. When the cornea loses its transparency or regularity, vision may become blurred or distorted.
Corneal diseases are diverse and may have infectious, inflammatory, genetic, or traumatic causes.
Corneal infections (keratitis)
These infections are caused by bacteria, viruses (such as herpes), fungi, or parasites.
They may cause:
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- Eye pain
- Redness
- Sensitivity to light
- Decreased vision
Prompt treatment is essential to prevent complications.
Inflammatory and allergic conditions
Certain chronic inflammatory conditions or allergies can weaken the cornea and impair its transparency, leading to discomfort and visual disturbances.
Keratoconus
Keratoconus is a progressive disease in which the cornea gradually thins and deforms, taking on a cone-like shape.
Keratoconus usually begins during adolescence or early adulthood and progresses slowly over several years before stabilizing in most cases. It affects both eyes but often asymmetrically (one eye may be more affected than the other).
Symptoms of keratoconus appear gradually and vary depending on the stage of the disease. The most common signs include:
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- Blurred and distorted vision: even with glasses, vision may remain unclear
- Irregular astigmatism: astigmatism is a curvature defect of the cornea; in keratoconus, it becomes irregular and difficult to correct with standard glasses
- Increased sensitivity to light (photophobia) and glare
- Double vision (diplopia), sometimes even with one eye open
- Frequent changes in eyeglass prescriptions without significant improvement in vision
- Difficulty seeing at night
The exact causes of keratoconus are not yet fully understood, but a combination of genetic and environmental factors appears to be involved:
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- Genetic factors: Keratoconus is more common in individuals with a family history of the condition. Several predisposing genes have been identified, but inheritance patterns are complex.
- Environmental factors:
- Repeated eye rubbing: excessive and vigorous eye rubbing is considered a major and modifiable risk factor
- Chronic eye allergies, which encourage eye rubbing, may promote keratoconus
- Wearing poorly fitted contact lenses
- Certain systemic diseases: associations have been observed with conditions such as Down syndrome, Ehlers-Danlos syndrome, or osteogenesis imperfecta
The diagnosis of keratoconus is made by an ophthalmologist during a comprehensive eye examination. The tests are painless and allow the ophthalmologist to confirm the diagnosis, assess disease severity, and monitor progression.
Treatment of keratoconus
There is no definitive cure for keratoconus, but effective treatments are available to improve vision and slow or halt disease progression. The choice of treatment depends on the stage and severity of keratoconus, its progression, visual acuity, tolerance to contact lenses, and individual needs. Regular follow-up with your ophthalmologist is essential to adjust treatment and monitor progression.
Living with keratoconus: advice and adaptation
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- Follow your ophthalmologist’s recommendations: contact lens wear, eye drops, follow-up examinations, etc.
- Avoid rubbing your eyes: this is essential to slow the progression of keratoconus. If you have eye allergies, treat them effectively to reduce itching.
- Adapting to specialized contact lenses for keratoconus may take time, but they are often essential for good vision
With regular ophthalmologic follow-up and appropriate treatment, it is possible to live well with keratoconus and maintain a good quality of life.
Corneal dystrophies
These are often hereditary diseases that cause progressive clouding of the cornea. They may appear in adulthood and progress slowly.
Corneal trauma and scarring
Trauma, burns, or foreign bodies can leave corneal scars, depending on their depth. If they affect the central cornea, they may cause lasting visual impairment.
Dry eye disease
Although common, dry eye disease can, in severe forms, damage the corneal surface and cause discomfort, irritation, and fluctuating vision.
Corneal diseases require accurate diagnosis and regular ophthalmologic follow-up. Treatments vary depending on the cause and severity and may include eye drops, therapeutic contact lenses, laser treatment, or specialized surgery.
